Abstract:

Background:
In early March 2020, the World Health Organized declared the COVID-19 outbreak a pandemic. Due to the rapid spread, strong contagion, high incidence of lethality in severe cases, and the lack of a pharmaceutical prevention or cure, COVID-19 it has posed a huge threat to human life and health and a tremendous impact on mental wellbeing. While nearly everyone has experienced the unease of this new COVID-19 world, medical students may be experiencing greater than average stress during this infectious disease outbreak. In addition to fear and worry about one’s own health precipitating changes in sleep or eating patterns, difficulty sleeping or concentrating, worsening of chronic health problems, and increased use of poor coping mechanisms, medical students have additional concerns regarding the interruption of their studies, closing of clinical rotations, and postponed licensing exams. The levels of medical students’ resilience, coping skills, and health behaviors, and the extent to which these factors affect their wellbeing during COVID-19 is unknown. Few reports have focused on medical students and their reactions to the outbreak. The purpose of this study was to assess resilience, coping, health behaviors, and emotional well-being among medical students during COVID-19.

Methods:
This cross-sectional study collected data from 202 medical students enrolled in a 4-year medical school in Florida, U.S. between March-May 2020 via an online, anonymous questionnaire using REDCap software. Major study variables were based on published reports and anecdotal evidence, which led to the development of the Emotional Wellbeing in Healthcare Professions Students Questionnaire (EWB-Q). The EWB-Q contained validated scales to assess levels of coping strategies uses, personal resilience or the ability to “bounce back” after a crisis) and how these variables might contribute to the emotional wellbeing of medical students. Multiple linear regression and other statistical analyses were conducted using SPSS v.26.

Results:
The mean age of the participants was 26.7 years; 40% were women. About half (45%) of participants were in their clinical training/rotations. The regression analysis indicated that the level of coping, personal resilience, and certain health behaviors (i.e., eating and sleeping well) explained 27% of the variance in emotional wellbeing scores in medical students during the first months of the COVID-10 pandemic in the United States. A significant regression equation was found, F(4,171) = 17.481, p < .000, R2 = .290, R2 adjusted = .274). Higher levels of resilience, greater use of coping strategies, getting enough sleeping, and eating well were predictors of emotional wellbeing.

Conclusions:
Mental health continues to take its place as an important consideration during crises and pandemics for all citizens, and cultivating positive mental health should be a goal for medical educators in as they develop and implement curriculum-based initiatives to help medical students bolster their personal resilience and to help encourage healthy coping behaviors during times of crisis and beyond. A proactive position to help build personal resilience and enduring stress management habits is paramount to help students who are grappling not only with the challenges of rigorous medical training, but the uncertainty and stress that exists during any major global health or socioeconomic crisis.

Keywords:

Medical student, coping, resilience, COVID-19, emotional wellbeing, mental health.